Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Multidetector CT Findings of Acquired Spondylolysis and Spondylolisthesis after Posterior Lumbar Laminectomy

요추 후방 감압술에서 발생한 후천적 척추분리증과 척추전방전위증의 다중검출 전산화단층촬영 소견

  • Hyein Yun (Department of Radiology, Ewha Womans University Mokdong Hospital) ;
  • Ji Young Hwang (Department of Radiology, Ewha Womans University Seoul Hospital) ;
  • Jeong Hyun Yoo (Department of Radiology, Ewha Womans University Mokdong Hospital)
  • 윤혜인 (이화여자대학교 목동병원 영상의학과) ;
  • 황지영 (이화여자대학교 서울병원 영상의학과) ;
  • 유정현 (이화여자대학교 목동병원 영상의학과)
  • Received : 2019.02.20
  • Accepted : 2019.09.03
  • Published : 2020.05.01
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Abstract

Purpose We aimed to analyze postoperative multidetector CT (MDCT) of acquired spondylolysis and spondylolisthesis after posterior lumbar laminectomy. Materials and Methods We enrolled 74 patients, from 2003 to 2017, who underwent posterior lumbar laminectomy with both pre and postoperative MDCT. The patients were categorized into the following two groups: group 1 without fusion and group 2 with fusion. We analyzed laminectomy width, level and location of spondylolysis or spondylolisthesis, facet changes, and fatty infiltration of paraspinal muscles on postoperative MDCT. Results Incidence of spondylolysis or spondylolisthesis was 4 of 20 patients in group 1 and 2 of 54 patients in group 2. The laminectomy width (%) was defined as the percentage of the width of laminectomy to total lamina length. Mean laminectomy width (%) in patients with spondylolysis or spondylolisthesis was 54.0 in group 1 and 53.2 in group 2, in contrast to that in patients without spondylolysis or spondylolisthesis, which was 35.0 in group 1. The spondylolysis was observed at the level of the laminectomy and below pars interarticularis in group 1 and below the fusion mass at isthmic region in group 2. Conclusion MDCT facilitates the diagnosis of postsurgical acquired spondylolysis and spondylolisthesis and demonstrates typical location of spondylolysis. Greater laminectomy width has been associated with occurrence of acquired spondylolysis and spondylolisthesis.

목적 이 연구는 요추 후방감압술에서 발생한 후천적 척추분리증과 척추전방전위증의 다중검출 전산화단층촬영 소견에 대해 분석하고자 하였다. 대상과 방법 2003년부터 2017년까지 요추 후방감압술을 시행 받고 수술 전 및 수술 후 다중검출 전산화단층촬영을 촬영한 74명의 환자를 대상으로 하였다. 유합술을 시행하지 않은 1군과 유합술을 시행한 2군의 환자로 분류하였다. 수술 후 다중검출 전산화단층촬영 영상에서 요추 후방감압술의 크기, 척추분리증 또는 척추전방전위증 유무와 위치, 척추전방전위증의 유무, 후방관절 및 척추주위 근육의 지방 변화에 대해 분석하였다. 결과 후천적 척추분리증 또는 척추전방전위증의 빈도는 1군에서 20명 중 4명, 2군에서 54명 중 2명이였다. 후방감압술의 크기(%)는 전체 추궁판에 대한 추궁절제술의 크기를 백분율로 계산하였다. 요추 후방감압술의 크기(%)는 후천적 척추분리증 또는 척추전방전위증이 있는 경우 54.0 (1군)과 53.2 (2군)이었고, 후천적 척추분리증과 척추전방전위증이 없는 경우는 35.0(1군)이었다. 척추분리증의 위치는 1군에서는 후방감압술 분절의 후관절 부근에서 발생하며, 2군에서는 유합술 하방의 관절 간부에 발생하였다. 결론 다중검출 전산화단층촬영은 요추 후방감압술 이후 후천적 척추분리증과 척추전방전위증을 진단하는 데 유용하고, 후천적 척추분리증의 전형적인 위치를 잘 보여준다. 요추 후방감압술의 크기가 클수록 후천적 척추분리증과 척추전방전위증의 발생과 연관이 있었다.

Keywords

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